The patients receiving the texts had a greater reductions in HbA1c levels at nine
months than control patients (mean change, −8.85 mmol/mol [0.81%] vs. 3.96
mmol/mol [0.36%]; adjusted mean difference −4.23; 95% CI, −7.30 to −1.15; P=0.007). They also showed significant improvements on four of 21 secondary outcomes:
foot care, overall diabetes support, health status on the EQ-5D visual analogue scale,
and perceptions of illness identity. Almost all patients (95%) said the intervention
was useful, and 97% would recommend it to others.

The overall reduction in HbA1c level did not reach the prespecified cutoff for clinical
significance, the study authors noted. However, the results at three and nine months
did show significant differences, suggesting that the “the intervention shows
promising effects on treating people with poorly controlled diabetes and warrants
further investigation.”

Another study, published by BMJ Open Diabetes Research & Care on May 21, assessed the potential of social comparisons of diabetes health status to improve patients' self-management. It was based on semistructured interviews with 25 patients with type 2 diabetes.
Seventeen of the survey patients expressed a desire for social comparison information
(i.e., self-evaluation in comparison with others) regarding their diabetes health
status. Slightly fewer (n=14) said that goal-based comparisons were important to their understanding of their
diabetes management.

The patients “commonly anticipated increased motivation and improved health
behaviors in response to both social and goal-based comparisons,” although
they also noted the importance of being compared to similar patients, the authors
said. Social comparisons could be incorporated into patient web portals and could
engage patients' competitiveness, appear more personalized than standard glycemic
goals, and inspire patients to learn from similar individuals with better self-management,
the study authors said.

Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. ACP Diabetes Monthly provides a monthly summary for internists about relevant news in diabetes. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated.